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Dr. Stuart McGill talks basketball backs, capacity and the importance of the hip hinge in his most recent interview.

Interview by Art Horne

Stu, in both your books and dvd’s you emphasize this concept of “capacity” and it’s importance, yet when discussing with sports medicine and strength colleagues this concept is still either misunderstood or not truly appreciated. Can you discuss this concept briefly and also touch upon how a collegiate basketball athlete can protect their “capacity” during the course of a day while attending classes, etc during a normal school day so that they are either able to be productive during a therapeutic exercise program later in the day or able to train at a high level without getting hurt?

Answer: Athletes have a capacity for work. On one hand it is important for most players to dedicate the majority of the training capacity for basketball. This is well understood. But consider the player who has an injury history, and the injury must be managed. Lets use the example of a flexion intolerant back. The BB player sits on the bench then, when standing up, takes a while to gain full extension of the spine and hips because of stiffness, discomfort, or even pain. Sitting (spine flexion) stole some capacity. Now consider off-court activities such as computer work (and more sitting) or driving to practice (more sitting with spine flexion). This used some of the spine capacity to train so that they will break into pain sooner during the BB training session. I would have to say that most flexion intolerant BB players I have consulted with did the damage in the weight room. They did not have the discipline of perfect form during squats and cleans, and ended up damaging the spine discs with flexion motion. The load associated with the squat and clean on long body levers really exacerbates this situation. So the original injury mechanism was repeated flexion bending of the spine under load. Subsequently, they are limited in the number of bending cycles their spine can undergo – this is their capacity. It is compromised. Now consider the player who brushes their teeth or ties their shoes with spine flexion. They just used up some of the tolerable bending cycles performing a non-BB activity. Discipline of movement form off court allows more of the capacity to be available for BB training. This is a concept that can be extremely important in getting nagging injuries better, and in enhancing on-court performance. Coaching this goes beyond BB specific training!

I often find most freshmen college athletes are not able to disassociate their backs and hips when arriving on campus to start a training program. Can you discuss the importance of the “Hip Hinge” in the basketball athlete and how you would teach it to an incoming athlete or someone rehabilitating from injury?

Answer: Athleticism comes from having great athletic hips – jumping, running acceleration, and cutting are all enhanced. However, for the hips to fully express their athleticism, the spine or core must be stiffened. Consider the vertical jump off a single leg takeoff. Here the power comes from explosive contraction of the hip extensor. But the core must be stiffened at this instant to prevent an “energy leak”, and a loss of power that should have been projected into the floor. So, the ability of the athlete to train hip motion with a stiffened core is paramount for enhancing on-court performance. This is also essential for off-court strength and speed training, where emphasis on hip power generation with a stiffened core enables a higher training load with more safety. Thus, the fundamental movement pattern we call the “hip hinge” is needed.Here we start standing, the palms are rested on the front of the thighs. Stiffening the core to prevent spine motion the athlete begins the squat motion with the hands sliding down the front of the thighs, and the hips travel back. As the hands reach the knees, carry the upper body weight down the arms resting on the knees. Now the knees should be over the mid foot. If they are not, pull them back by moving the hips back.Now when standing up, simply slide the hands up the thighs and pull the hips forward. But ensure the knees remain over the mid foot. This ensures a perfect hip hinge. It enhances performance and safety!

In your video, The Ultimate Back: Enhancing Performance you discuss the importance of an Anchor Point or in Latin a “punctum fixum” – can you discuss exercises in which basketball athletes must be clearly proficient in prior to engaging in rotational medicine ball exercises?

Answer: This also goes back to the previous question. Explosive hip motion requires the core to be stiffened or locked. Try a lateral stepping drill with a soft core and the hips are slow. But then stiffen the core and the hips are able to snap and explode. This is because the core is now the “fixed point” for the hip muscles to pull from.For me the rotational med ball exercise is a slightly different issue. I have been brought in as a consultant to Pro teams after the players started with back pain. A previous consultant had them throwing med balls sideways explosively, into a wall. They damaged their discs with repeated twisting. They did not understand that the discs will damage doing this. The only way to protect against this is to rotate about the hips and not the spine. The core muscles are designed to stop motion, not create twisting motion. The hip joints and muscles are designed to be the power generators. So here, a fixed core prevented injury and allowed a higher tolerable training capacity. But it also increases athleticism too.

In general, what logical progression that you would follow when dealing with a freshmen basketball athlete based on the above? (example: front bridge then front bridge with 4-point lifts, to prone touches, etc).

Answer: This really depends on the athlete and as you know I can only decide this after I have performed an assessment to determine the balance between their various fitness attributes. I need to see if any movement flaws exist which need correction. Then work on hip mobility and power generation and stability in the core. Then move on to endurance, strength and full power and speed production. This process is detailed in my “Ultimate back fitness and performance” book.

You mention the importance of the latissimus dorsi as a stabilizer throughout the video, yet many strength coaches and basketball athletes train them primarily as a pulling muscle through chin-ups and not as the massive lumbar stabilizer that you make them to be. Can you expand on their importance in preserving the spine during strength training?

Answer: This is an interesting question and one of culture. In Russia you would not be even asking this question because emphasis on the lats is ingrained in their training culture. For example, when performing a bench press, “bending the bar” through the sticking point with latissumus dorsi is common in Russia yet I have to coach this in North America. The same can be stated when squatting with a bar across the shoulders. At the bottom of the squat the athlete focuses on hip abduction together with lat contraction. This stiffens the spine, adds back extensor torque, and facilitates the hip extensors. It results in a higher lift with less risk of injury. Again, this is not well practiced in North American training but is a staple in Russia. This is just one technique where performance is enhanced together with a reduced injury risk – a real win-win.

Obviously with basketball athletes there is a concern with long levers and subsequently tall spines, what exercises should strength coaches either avoid or be very strict when prescribing and coaching?

Answer: Again, I have to state that I could only answer this after assessing the athlete. But as a general approach I would probably avoid deep squatting a 7 foot tall center and focus on creating hip power off one leg over the short range to mimic a foot plant with a single leg takeoff. Again – this is short range hip extensor explosion with a stiffened core. That’s how the great ones take off from the top of the key and dunk a BB!

Thanks for your questions Art – keep up your great work. Remember I learn from you with your “on the court experience” as much as you learn from me with our mechanistic investigations.

For more information, or to order McGill’s dvd’s and books, visit backfitpro.com.

Andy Weigel

How and why did you get into the field of strength and conditioning?

I moved out of Wisconsin in 2001 to Daytona Beach, Florida. After a short stint working in a deli, I started working at a health club and soon became a personal trainer. I knew very little but I worked hard and made good money. However, I knew that this wasn't going to be long-term thing. I had a passion for sports, especially basketball. If only I could find a way to combine the two. I finished my associate's degree in Daytona Beach and transferred to University of Florida. Fast forward to the summer of 2005, I was a physiology and kinesiology major, sitting in a coaching class. The kid sitting next to me was a basketball manager, Kyle Gilreath. We spoke on a daily basis about the basketball program and I had no clue the structure or how a college team worked. After Kyle explained they had their own strength and conditioning coach I asked if he'd introduce me. I went to the Florida Basketball facilities where I was introduced to Matt Herring. We spoke for almost 2 hours and Matt offered for me to be a "fly on the wall," for the rest of summer. I took that opportunity to heart and 5 years later, I'm the basketball strength coach at Alabama.

How has your training philosophy changed in the last 3-5 years?

My philosophy hasn't taken a 180 in the last 3 years but I have solidified and enhanced my knowledge of my beliefs. I have also widened by horizons by looking at a lot of other coaches. I truly believe that basketball players need to be trained functionally; using the ground, gravity, momentum through tri-plane movement. That gets misinterpreted as crazy lunges, reaches and jumps. I even thought that at one point. I really think it's following our anatomy and functions of how we're programmed and training it efficiently and effectively. That doesn't have to be crazy; it can be kept very simple and organized. For a while I had a huge toolbox and was willing to try every tool to see what it did. Now I have a huge toolbox with organization and purpose. I also have seen that no matter what style or philosophy you have it truly isn't the most important thing. How you do what you do is by far the most important thing. If all you do is squat and bench than do that with all your heart and make your players believe that it's getting them to be the best. I now realize that X's and O's are important but how I implement those is more important.

What are the 3 biggest mistakes a basketball player makes when it comes to strength and conditioning?

I'm going to pace myself for conditioning to make it through; last set best set, I'm giving 110%. This is a huge pet peeve of mine. We'll be doing a conditioning test where the players are struggling to make their times at 35 seconds. Our head coach will yell out, "If you make the last run in 32 seconds than you don't have to run the last 2. And magic, guys are making their runs in 28 seconds. Give your best as much as you can. It is impossible to give 100% all the time, impossible in my eyes to give 110%. You'll be in better condition in the long run if you give that type of effort all the way through. I don't want to get too big! I'm too skinny I need to get huge! Another huge mistake players confuse themselves with is body weight. Is their size inhibiting them from being better? I think each individual has their own zone of body weight and size that is optimal for themselves. I also believe body composition is just as important as body weight. The guy who gained 15 pounds has now increased his body fat percentage by 3 has probably not helped himself. Let coaches help determine the best needs not a guy on a school blog or NBA draft guru.I want to get on LeBron's plan! I heard Dwight Howard does this! That's great; do you have LeBron's skill or athleticism or Kobe's desire, work ethic, and discipline? LeBron, Kobe, Dwight, and others all have their workouts for them. Your individual needs are very different. Some of the things they do may be great but that doesn't necessarily mean that it's what you need.

There has been a lot of debate about the squat and single leg training? In your opinion, should basketball players squat? Year round? Only Summer? Never?

Players love to compete whether it's on the court or in the weight room. How do you create a competitive environment in the weight room?

I like to use competitions when appropriate. I'll also use themes for whoever we'll be playing a certain week. I think that negative comments all the time do not work. I'm trying to focus on building a culture of intensity through positive and rewarding words. I'm afraid that if I bring up the bad that's all my guys will remember, what they can't do or how they got beat. I need them believing more in themselves and what they can do, than they even know. I continuously try to create a vision for each workout. Recently I've told the guys Friday's will be tight shirt day. I even put my Nike Pro on with them. Freaky Friday's are some of our best workouts! This is an underrated category; this is an area that speaks about how you do things. If used correctly I think this can create an immense mental advantage of your players.

I think squatting is great. I also think it can have negatives. If it's in your philosophy to squat then squat! With basketball players I think it's essential to understand the differences in body size and therefore the impact a squat has on the player. The current group I have has 4 really good squatters and 4 who are not so good. I'm working on improving their form but also realize that I'm not going to load a guy with 225 on his back just to say we squatted. I think that hurts him. The 4 who can squat will squat. The others we'll create a squat or exercise to make them successful. It it's appropriate in-season and the players are capable we'll squat. I'll also use various forms of the squat ranging from foot stances, dumbbells, heel elevated, keiser squat, bodyweight, or using a vest. I love single leg training as well. I find lots of asymmetries that I can address by using single leg work. Sometimes the squat is a disguise to some issues. We do so much work on 1-leg it's important to train that way.

Art Horne

1. How did you get into the field of sports medicine / strength and conditioning?

I originally started working at Northeastern University in the summer of 2003. At that time I came on as the athletic trainer working with Men's Soccer, Men's Basketball and Baseball. Needless to say there wasn't a lot of time to hone my skills as an athletic trainer, let alone become a strength coach. However, during that time I became good friends with the strength coach for Men's and Women's Basketball team, Ray Eady, who I will forever be indebted to for teaching me the ropes at the Division one level. Ray did such an amazing job with our team that he was hired on at the University of Akron as their basketball Strength Coach and now works at the University of Wisconsin with the women's program there. With Ray's departure from Northeastern, the door was left open for me to step in and continue Ray's programming while implementing some of my own philosophies. Since that time I have been able to merge both athletic training and strength training into one performance philosophy with our basketball team and now have the opportunity to do so with our entire student-athlete population in my new position of Director of Sports Performance.

2. Who in the field has influenced or helped you the most? Influence your training philosophy? What have you learned from them that you can you share?

As I mentioned previously Ray Eady had a tremendous impact on the way I evaluate and train the basketball athlete. Prior to Northeastern, I was fortunate enough to be mentored by four of the smartest athletic trainers in the business, Pete Koehneke, Andy Smith and Mike Dolan at Canisius College and Mark Laursen, Director of Athletic Training Services at Boston University. While I was at Boston University I was able to take graduate courses with Mike Potenza, (current strength coach for the San Jose Sharks), and learn from current Director of Strength and Conditioning Glenn Harris as well as Mike Boyle. Most recently, I have been fortunate enough to be able to discuss training concepts with Dr. Stuart McGill with particular focus on the basketball athlete.

For anyone that hasn't read McGill's work, stop reading this and go get anyone of his books or dvd's!

McGill brings an evidence based approach to both his evaluation process and training programs. If you've worked with a basketball athlete you've surely observed the very tall spine of the basketball athlete and have discussed with friends whether this body type has the ability to handle various exercises without causing problems. Regardless of which side of the fence you sit on with regards to the front squat, back squat, Olympic lifting or other, McGill's stabilization exercises are a must for all basketball athletes looking to preserve their spine health. In personal communication with Dr. McGill, an emphasis in frontal plane stability may very well be of paramount importance while planning a training program for this sport and ultimately performance on the court.

To illustrate this concept, simply think about a guard crossing over a defender and the need to rapidly and efficiently contract, then relax his left lateral line (Obliques, Quadratus Lumborum and Glute Medius) to push from his left to his right, followed by the same rapid and efficient contraction followed by relaxation of the right lateral line as he plants his right foot and crosses back over to the left to beat his defender.

I've made a number of changes in our programming to not only address, but emphasize the frontal plane, especially for guards by including asymmetrical kettle bell lunges, farmer carries and a variety of side bridges to name a few.

3. Name 3-5 books every professional working with basketball athletes should have in their library and why?

In a recent post entitled, "Must reads that have nothing to do with strength" I outlined books that I think every strength coach should have in their collection, but this certainly holds true with athletic trainers, physical therapists and anyone who cares for the basketball athlete. The normal list includes the following:

Diagnosis and Treatment of Movement Impairments by Shirley Sharman

Anatomy Trains by Thomas Myers

Low Back Disorders by Dr. Stuart McGill and

Athletic Body in Balance by Gray Cook to name a few.

The two that I make special mention to however related to professional development, a concept many involved in athletics sometimes forget about due to travel with teams, administrative duties and pure number of hours engaged at work. If you get a chance during a plane ride this coming season, or during this summer vacation time check out Good to Great by Jim Collins and Never Eat Alone by Keith Ferrazzi.For a complete review of both books visit "Must reads that have nothing to do with strength"

4. What assessments or evaluations do you use with your players during pre-season?

Besides the traditional screening protocol and questions that all athletic trainers and sports medicine departments put incoming athletes through, we have utilized the following examination with all of our Men's Basketball athletes in previous years:

Vision Screening: we've found that many of our athletes either have never had a full eye exam, or the lenses/glasses that they currently use are not up to date. After evaluation, a minor tweak in their prescription makes a significant improvement both on the court and in the classroom.Concussion Screening: establishes a baseline to help determine return to play if a concussion were to happen.Functional Movement Screen: We test all basketball athletes anywhere from 3-4 times per year with scores of either zero or one being referred to the Sports Medicine department, (and ultimately me) for a full orthopedic evaluation. Corrective exercises are then prescribed and inserted at the beginning of training sessions and/or given as "homework" for the athlete to complete on their own time.Goniometry measurements: including ankle dorsiflexion in prone position, passive knee extension with hip at 90 degrees, passive knee flexion in modified Thomas test position.Tender Points Evaluation: lateral gastroc, lateral hamstring, glute medius, lateral quad, thoracic spine, and adductors. We then address these globally with foam rolling, stretching or other soft tissue work. Some individual active release techniques may have to be incorporated on a one-on-one treatment program within the Sports Medicine Department.Left/Right single leg broad jump discrepancy: hands on hips, single leg jump and hold - looking for difference in strength and ability to hold landing. Differences over 10% are noted, with differences over 15% given special exercise programming to address this deficiency. Previous Injury: we make a special effort to exam and address all previous injuries, even those that are not causing any pain or disability during examination - regardless of how minor they may have been. If an athlete has been injured in the past, evidence supports that they are more likely to be injured again in the future. This holds especially true for those incoming freshmen who may not have properly rehabilitated their injury at their previous high school or prep academy.

Adam Naylor

How and why did you get into the field of sport psychology?

Sport psychology is what I was headed towards for a long time. Growing up, I was not allowed to watch TV on school nights unless it was sports; therefore learned that there was some intrinsic value to sports. Furthermore, my father was a congregational minister and as far as I can figure he did and still does most of his pastoral counseling on a basketball court. You could say I am the second in my family to work in sport psychology.

After these initial foundations, I did my first research study in sport psychology as a senior in high school (on between point routines in tennis), taught my first collegiate sport psychology class as a senior at Trinity College, and did my first official applied sport psychology work during the first year of my graduate studies at Boston University in 1996, and as they say, the rest is history.

Who in the field has influenced or helped you the most? Influenced your philosophy? What have you learned from them that you can you share?

I have really been influenced by a great many people from within and outside of the field of sport psychology. Currently, my greatest influences are my peers in the Professional Sport Psychology Symposium (Dr. Doug Gardner, Dr. Ed Kingston, and Matt Cuccaro). We challenge each other’s thinking daily, share new research regularly, and simply push each other towards serving athletes and coaches as best we can. It is great to have a bunch of colleagues that have worked with high school athletes through professionals in most every sport with whom to brainstorm.

Name 3-5 books everyone helping basketball athletes should have in their library and why?

The Power of Mindful Learning by Ellen Langer because learning is just about everything when it comes to developing as a player. The player that learns the best tends to make the greatest gains. This is a quick read that dispels many myths about how we learn and gives insights into optimal approaches to learning.

Mindset by Carol Dweck is a solid read that highlights the flaws with being an “ability-focused” individual rather than an “effort-focused” player. It is a good read for athletes, coaches, and parents.

How We Decide by Jonah Lehrer is an interesting read that gives some practical insights into decades of research in neuroscience. It is good for a basketball player because basketball is a game where quality decisions need to be made in a split second on the court. Understanding why and how we make good and bad decisions is clearly valuable.

Priming Performance: A Collection of Writings for Consistent Mental Toughness by Adam Naylor is written for the athlete and can be used as a workbook. O.k…a shameless plug for my own book, I admit… sort of. This was written as a mental training resource that is accessible and practical for the competitive athlete. Copies can be purchased at http://stores.lulu.com/telosspc.

What is the last book you read and why?

I just finished The Opposable Mind: Winning Through Integrative Thinking by Roger Martin. I read it because I truly believe that excellence in leadership, coaching, and sport requires integrative thinking. This is a refusal to accept conventional options and the undesirable trade-offs that seem to accompany “real world” problems. The integrative thinking finds creative solutions challenging problems.

Generally speaking, what is your philosophy for evaluating/treating a basketball player? How does it differ from other sport athletes?

The two big things I do when I evaluate any athlete are to get a sense of their goals/motivation and learn how they respond to adversity. The athlete that is motivated by learning each day and competing with himself regularly has a great foundation for success. Secondly, any athlete can play well when he is feeling good or is in the zone, but the great athlete succeeds when things are off and the game is a struggle.

Perhaps unique to basketball, I like to take a good look at how the athlete works with teammates and responds to coaches. The basketball team is so small and the environment so intense, it is important to be an effective communicator, take feedback well, and remain motivated regardless of the ups and downs of the team dynamic.

What has been the biggest mistake you made early in your career?

Early in my career, it was very difficult to “allow” an athlete to be uncomfortable. During work with individual athletes I was too quick to lend a helping hand or make them feel better. A modest level of discomfort is necessary for genuine cognitive change to occur. Unless we truly take time to assess and challenge ineffective thinking it is unlikely we can adopt a more productive mindset for the long term. Now if an athlete is “struggling towards success” I will support him through the journey, but will only throw out a life preserver if he is drowning in an unhealthy or ineffective cognitive spiral.

How has your philosophy changed in the last 3-5 years?

I don’t know if I’ve dramatically changed my philosophy over the past few years, rather I have simply added pieces to it. The one thing that I feel more strongly than ever about is that my work is about player development not simply teaching of mental skills. Goal setting, mental imagery, and the rest are valuable tools, but the seasoned sport psychology practitioner ought to be able to understand the social, psychological, and developmental needs of a player at the various stages in a basketball career.

What advice would you give for young professionals looking to follow in your footsteps?

Hone and refine your craft - truly become an expert. Too many young professionals want to work in applied sport psychology so badly they rush to open their mouths and fail to appreciate primary research and gain a depth of understanding about psychology and its practice. Too often this leaves them little more than motivational speakers with a graduate degree. I suggest, taking many years working “athlete’s hours,” listening to coaches, and reading the “tough” scientific reads. This leads to a depth of knowledge that leads to a long and successful career.

What areas do you address for those players that don't play significant minutes during the in-season?

With players that do not play significant minutes, I focus on maintaining motivation. This can happen a few different ways: 1. By serving as a “bitch board.” I am a safe spot where a player can vent frustrations, 2. By helping them appreciate and embrace their role, 3. By helping ensure quality practices regardless of playing time, 4. Lastly, by keeping minutes in perspective so they are able to perform well when their number is called.

What recovery methods have you implemented with your athletes during the season? During tournament play?

Mental recovery is just as important as physical recovery to assure excellent play. Monitoring stress levels and sleep is key. Furthermore, helping athlete chose time when focus is necessary and when they can simply flake out helps regulate cognitive energy.

During tournament play, it is important that players focus on the right things at the right times. This means when the ball is in play, play. When the game is over, reflect and learn. Between games, rest. Before the next game, refocus.

What arousal strategies would you employ for an athlete prior to competition?

There are myths on both ends of the spectrum on this one. First, a player can be too pumped up to play well. Secondly, a player can be too relaxed, hurting one’s ability to find the explosiveness and focus necessary for success. With this in mind an athlete’s self-awareness is critical to pre-game prep. Taking some time to determine what is the right emotional level for “me” is important. A nice way to formalize this is to pick an adjective that sums up one’s optimal feeling and focus at tip off. Answers could range from “mellow” to “pumped.” Whatever a player’s word might be, it does give a clear target for one to strive towards during the day, hour, minutes leading up to the start of the game.

Pre-game mental prep is a true mind-body experience. Meaning, the mind ought to find focus while the body finds a level of relaxed-energy that will lead to good play. A simple way to focus the mind is to remind one’s self of two keys to success for the upcoming mind. There are a variety of ways to manage one’s physiological arousal. A few good diaphragmatic breathes are perhaps the simplest approach. They can be done while stretching, reviewing a game plan, or moments before tip off. A good breathe is a great skill as it both energizes and relaxes the body, while being a simple skill to add to pre-game prep. Regardless of how one focuses his mind and body, it is important to be consistent and committed to the approach in order to lay the foundation for great performances.

What would you suggest basketball athletes do prior to shooting a foul shot?

Have a simple pre-shot routine. A simple three step process is: Relax – Rehearse – Refocus. Relax after the foul or the previous shot. Take a few moments to slow your heart rate. Rehearse by either mentally or physically doing a dress rehearsal of the shot. Refocus narrow your focus to a small target at the hoop or a simple idea in one’s mind (i.e. “smooth). Then shoot. In essence get control of your mind and body and then commit to your shot.

What Recovering from injury?

When recovering from injury, don’t be mentally tough. Yes, it sounds strange, but research has shown that mental toughness or an overly determined mindset when injured only leads to further injury or poor recovery. The art to rehab is to be both patient and persistent in the training room and at the gym.A player does not have to enjoy being injured, but he should take advantage of the opportunities injury presents. Being injured affords a player to look at practices and games from a different perspective. When healthy, a basketball player gets few chances to sit back to watch plays fully evolve and to appreciate the subtleties of the game. The wise injured athlete takes this all in to be better upon return to play. Furthermore, injury provides an opportunity to rest and recover. A season can be mentally taxing. Although the break is unwanted, taking advantage of the opportunity to recharge leads to sharper play upon return. Injury stinks, but one can continue to grow and develop even with limited physical capacity.